Provider Demographics
NPI:1821357732
Name:CASEY, ANN MARIE (PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:ANN MARIE
Middle Name:
Last Name:CASEY
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:MISS
Other - First Name:ANN MARIE
Other - Middle Name:
Other - Last Name:MCKAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1166 E WARNER RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-3064
Mailing Address - Country:US
Mailing Address - Phone:480-570-0497
Mailing Address - Fax:480-452-0145
Practice Address - Street 1:1166 E WARNER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3064
Practice Address - Country:US
Practice Address - Phone:480-570-0497
Practice Address - Fax:480-452-0145
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4476363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAP4476OtherAZBON